Bitcoin continues its bullish momentum from its recent low of $11,125 on August 11 and is currently trading near the $11,600 level.
On Monday, August 11, gold and silver showed some corrective movements, and the same was seen in the cryptocurrency market, where Bitcoin fell by $700 from $11,800 to $11,125 in one day, indicating a short-term correction.
Analytical data showed that the correlation of Bitcoin with gold reached an all-time high, and the data indicated that the correlation provided support for what is said about the currency as a “store of value” and a suitable alternative to the traditional currency prone to inflation, as it showed it as digital gold.
Despite the positive sentiment towards Bitcoin as a store of value asset, gold can interfere with its price, and the price of the coin fell by 5% on Monday in a move close to the price of gold which has seen a decline in value.
Bitcoin is falling from the level 12000 dollar
Given the current recovery of the currency, it seems that the bullish momentum still dominates the crypto markets, if Bitcoin wants to maintain the bullish market, the critical support is between 11100-11300 dollars, and once it loses this level, expectations indicate that the price will record a significant decline towards the 10000$ area.
The world's largest cryptocurrency rejected the $12,000 resistance level for the second time in the past 10 days, however, traders are generally optimistic about the short-term trend for it, as when the asset remains relatively stable near a major resistance area it is usually a sign that the uptrend may continue.
The price correlation between bitcoin and gold is a topic that has sparked controversy among analysts during the past period, during the month of July the price movement between the two followed new highs, and therefore it is not surprising that the currency is now correcting along with gold and silver.
Optimism about the future of Bitcoin as an alternative currency
MicroStrategy, the world's largest public trade intelligence company, announced this week that it is giving up fiat currency and creating a primary treasury reserve using bitcoin.
The company's CEO, Michael Saylor, believes that the Corona virus pandemic and the stimulus measures enacted to combat it will lead to a significant decrease in the real long-term value of fiat currencies and many other types of traditional assets.
Saylor explained that Bitcoin is a reliable store of value and an attractive investment asset with more long-term appreciation potential than holding cash.
Cryptocurrency market recovery
In recent weeks, the cryptocurrency market has witnessed a significant increase in the demand for assets with small and medium market capitalization, with altcoins outperforming bitcoin significantly since the beginning of August.
In the medium to long term, strong performance from altcoins could spur Bitcoin higher, past price cycles show that a big rally in altcoins is followed by a rally in profit taking as returns stream into Bitcoin and Ethereum.
The total cryptocurrency market capitalization is now around $354.2 billion, and the Bitcoin Dominance Index recorded a reading of 60.5%, the lowest value since the price peaked in June 2019.


At the October Board meeting, PWSA awarded its $8.4 million Rising Main 4 Improvements Project to Structural Preservation Systems LLC. This project, part of our Water Reliability Plan (WRP), will renew a key distribution pipe.
Rising Main 4, located in Highland Park, is a large-diameter water main that moves water from Bruecken Pump Station to water storage systems in Highland Park. This project is phase two of our efforts, with the rehabilitation of nearby Rising Main 3 wrapping up in the winter.
As part of this project, crews will line 50- and 48-inch diameter steel pipe and 48-inch diameter concrete pipe with a carbon fiber reinforced polymer (CFRP). This trenchless method of restoration was selected after the design process. Some sections that cannot be lined will be replaced by digging.
Crews will also complete additional condition assessment using electromagnetic technology on a portion of pipe that was not previously surveyed during the design process. Conducting this survey involves lowering a team of skilled technicians into the pipe where they visually inspect its interior condition and perform a robotic inspection using electromagnetic waves to detect deficiencies in the pipe.
The Rising Main Improvements Project will be funded by a mix of PENNVEST and federal loans, saving our ratepayers money over time. PWSA will pursue this type of funding for as many projects across its Capital Improvement Program as possible. Construction is anticipated to begin in March 2023 and finish by the end of year. Read more about this project and other WRP upgrades on our Water Reliability Plan webpage.


Helicobacter pylori eradication for primary prevention of peptic ulcer bleeding in older patients prescribed aspirin in primary care (HEAT): a randomised, double-blind, placebo-controlled trial. Hawkey C., Avery A., Coupland CAC., Crooks C., Dumbleton J., Hobbs FDR., Kendrick D., Moore M., Morris C., Rubin G., Smith M., Stevenson D., HEAT Trialists None.
BACKGROUND: Peptic ulcers in patients receiving aspirin are associated with Helicobacter pylori infection. We aimed to investigate whether H pylori eradication would protect against aspirin-associated ulcer bleeding. METHODS: We conducted a randomised, double-blind, placebo-controlled trial (Helicobacter Eradication Aspirin Trial [HEAT]) at 1208 primary care centres in the UK, using routinely collected clinical data. Eligible patients were aged 60 years or older who were receiving aspirin at a daily dose of 325 mg or less (with four or more 28-day prescriptions in the past year) and had a positive C13 urea breath test for H pylori at screening. Patients receiving ulcerogenic or gastroprotective medication were excluded. Participants were randomly assigned (1:1) to receive either a combination of oral clarithromycin 500 mg, metronidazole 400 mg, and lansoprazole 30 mg (active eradication), or oral placebo (control), twice daily for 1 week. Participants, their general practitioners and health-care providers, and the research nurses, trial team, adjudication committee, and analysis team were all masked to group allocation throughout the trial. Follow-up was by scrutiny of electronic data in primary and secondary care. The primary outcome was time to hospitalisation or death due to definite or probable peptic ulcer bleeding, and was analysed by Cox proportional hazards methods in the intention-to-treat population. This trial is registered with EudraCT, 2011-003425-96. FINDINGS: Between Sept 14, 2012, and Nov 22, 2017, 30 166 patients had breath testing for H pylori, 5367 had a positive result, and 5352 were randomly assigned to receive active eradication (n=2677) or placebo (n=2675) and were followed up for a median of 5·0 years (IQR 3·9-6·4). Analysis of the primary outcome showed a significant departure from proportional hazards assumptions (p=0·0068), requiring analysis over separate time periods. There was a significant reduction in incidence of the primary outcome in the active eradication group in the first 2·5 years of follow-up compared with the control group (six episodes adjudicated as definite or probable peptic ulcer bleeds, rate 0·92 [95% CI 0·41-2·04] per 1000 person-years vs 17 episodes, rate 2·61 [1·62-4·19] per 1000 person-years; hazard ratio [HR] 0·35 [95% CI 0·14-0·89]; p=0·028). This advantage remained significant after adjusting for the competing risk of death (p=0·028) but was lost with longer follow-up (HR 1·31 [95% CI 0·55-3·11] in the period after the first 2·5 years; p=0·54). Reports of adverse events were actively solicited; taste disturbance was the most common event (787 patients). INTERPRETATION: H pylori eradication protects against aspirin-associated peptic ulcer bleeding, but this might not be sustained in the long term. FUNDING: National Institute for Health and Care Research Health Technology Assessment.


Weight loss is a $33B annual economy, with 45 million Americans going on a diet each year. However, nearly two-thirds of the population continue to struggle with weight. Why?
Traditional diets leave us frustrated, tired, hungry, and discouraged. They typically consist of:
“Rapid, unsustainable weight loss, Black-and-white categorization of foods as ‘good’ or ‘bad,’ Unsustainable eating habits, Unrealistically restricted calorie consumption, and Progress only indicated by numbers on the scale.”
To markedly improve your chances of making sustainable, more comprehensive progress toward your health goals, the article suggest you can instead:
“Eat healthy, nutritious, and whole foods to nourish your body, Practice moderation, not restriction, Exercise on a regular and consistent basis, Rely on your body to tell you what you need, Lose weight at a safe and healthy pace ( 1-2 lbs per week), and Measure progress beyond a number on the scale.”
When you shift your focus to long-term lifestyle changes, you will notice a difference in your journey to a healthier weight that involves less stress and longer-lasting results.


The most accurate seasonal insights. Made easy to use.
Salient delivers forecasts for precipitation, temperature, and other weather variables at up to 1/4° (25km) spatial resolution. Our models provide global coverage and can be customized to include optimized predictors and accuracy for smaller regions. Salient’s forecasts also serve as the foundation for powerful industry-specific analytics that help drive profitability and better business outcomes.Industry Analytics
Forecast timescales
Our subseasonal-to-seasonal forecasts are issued on a weekly basis. Long-range forecasts are issued every month.
Sub-seasonal forecasts
1-5 weeks
Seasonal forecasts
1-30 days, 31-60 days, and 61-90 days
Long-range forecasts
1-3 months, 4-6 months, 7-9 months, and 10-12 months
Interface options
We provide forecasts for a wide range of weather variables, and a variety of ways to interact with them.
Decision tools
Salient shortens your time to insight by coupling our forecasts and industry analytics to decision tools including threshold alerts, recommendations, and more.
Map interface
Salient’s web-based interface includes forecast maps, probability plots, historical performance graphs, and comparison forecasts at multiple spatial and temporal scales.
APIs
We provide raw forecast data in gridded NetCDF format through APIs that can be integrated into digital products, dashboards and virtually any forecasting tool.
Our methodology
Salient’s models are built on new insights into ocean and land data, research-based weather analysis techniques, and deep neural network architectures that we are relentlessly iterating and improving upon.
Billions of climate predictors
We employ global datasets of ocean, land, and atmospheric data to gain a unique and more robust picture of the factors that actually drive seasonal weather patterns.
Extracting predictability
Our model is continuously updated with recent climate observations, and integrates outputs of numerical models like GFS and ECMWF.
Always learning and improving
We are constantly testing and adjusting our models, and integrating the latest breakthroughs in machine learning to improve our forecasts and skill.
Quantitative evaluation of risk
Our forecasts include probabilistic distributions of outcomes to provide a comprehensive view of risks and the likelihood of extreme events.
Explaining physical connections
Salient is breaking ground in describing clear and non-obvious physical “teleconnections” in our machine learning model outputs.
Industry-specific analytics
We extract industry-specific forecasts to deliver meaningful insights to enterprise customers, covering a variety of formats and variables.
Rigorous backtesting for unbeatable accuracy
Salient offers a 30-year library of backtesting data that allows customers to validate our results and understand the true potential of our models. We use a rigorous cross-validation methodology to ensure our models perform well across the full spectrum of seasonal weather conditions. All forecasts are backed by a large probabilistic ensemble which reveals the range of potential weather outcomes for a given period.
Explore our research
Salient's forecasts are built on top of decades of foundational research into ocean conditions, climatology, and the global water cycle. Our team leads path-breaking research on concepts that have deepened scientific understanding and advanced numerous disciplines.


The International Ethics Standards Board for Accountants (IESBA) has revised its definition of public interest entities (PIE).
The revised provisions specify a broader list of categories of entities as PIEs whose audits should be subject to additional independence requirements to meet stakeholders’ heightened expectations concerning auditor independence when an entity is a PIE.
The revisions: Articulate an overarching objective for additional independence requirements for audits of financial statements of PIEs. Provide guidance on factors to consider when determining the level of public interest in an entity. Replace the term “listed entity” with a new term “publicly traded entity,” providing a definition of the latter term. Recognise the essential role local bodies responsible for the adoption of the Code play in delineating the specific entities that should be scoped in as PIEs in their jurisdictions, encouraging them to properly refine the PIE categories and adding any other categories relevant to their environments. Introduce a transparency requirement for firms to publicly disclose the application of independence requirements for PIEs where they have done so.
IESBA chair Gabriella Figueiredo Dias said: “The concept of a PIE is central to the application of the IIS and determines how far an auditor must go in meeting the fundamental requirement to be independent. The revised definition and related provisions represent the third pillar in our package of measures to significantly strengthen auditor independence in the public interest, following the release of our revised Non-Assurance Services and Fees standards last year.”
The revised PIE definition and related provisions become effective for audits of financial statements for periods beginning on or 15 December 2024. Early adoption is permitted and encouraged.


Aligning Wealth with Your Values Through Thoughtful, Personalized Planning
Philanthropic giving is deeply personal. Some of our clients have a giving tradition passed down through generations based on core values, while others are charting a path to ensure a lasting legacy for their heirs.
There are many strategies that can be used to optimize charitable goals, so our approach is to apply our experience and expertise to identify the best fit and then help execute.
How We Serve Charitable Investors Philanthropic Mission Statements
A mission statement is a few sentences that crystalize the purpose and scope of your giving. It makes your charitable efforts more effective because it is based on what matters most to you and your family, it provides an outline for action, and it will help you feel more connected to your causes.
Charitable Strategies
Our goal is to help you maximize your investment which may include donation of appreciated securities, donor advised funds (including community foundations), qualified charitable distributions, family foundations, charitable remainder trusts, and donating privately held securities such as private equity or limited partnership interests.
Estate Planning
Our advisors bring their expertise in partnership with our dedicated trusts and estates team to ensure the philanthropic wishes of our clients are incorporated into their estate plans. This ensures clarity for beneficiaries and empowers them to act on our clients’ behalf, ensuring a legacy that will last for future generations.
Our Dedicated Team
Our advisors understand the complexities of thoughtful, lasting philanthropic giving, particularly across generations. Their goal is to take the time to understand the wishes of their clients and help them in creating a meaningful plan for giving that maximizes the most current tax strategies, ensuring their investment makes the most impact. In addition, they’re also personally committed to serving their communities and many of them serve on Boards of local nonprofits that align with their values and mission. Looking for a financial advisor?


Whenever you buy goods on credit without paying cash up front, you have created an “Accounts Payable.” A common scenario is when you purchase materials from a supplier and the invoice needs to be paid back in 30 days. Accounts payable are liabilities to your business and are recorded as current or short-term liabilities on the balance sheet. Accounts payable must be settled relatively quickly to avoid default.
Tip
To calculate accounts payable on your balance sheet, add up the totals of all the invoices you have approved but not yet paid.
What Is Included in Accounts Payable?
Accounts payable covers any bill amounts you have accrued and will need to pay soon. These include shipments with terms from suppliers and current utility statements. It does not include long-term debt such as term loans and credit card balances. If you pay an accounts payable item with a credit card, the sum becomes part of your long-term debt rather than part of accounts payable. The total amount of your liabilities won't change this payment because you will have transferred debt from one type of liability to another. However, you will have decreased the amount you owe as accounts payable.
How to Calculate Accounts Payable
If your enter bills and schedule payments using a computerized accounting system such as QuickBooks, you can calculate accounts payable by running a report that summarizes the bills you've entered but not yet paid. But you don't need an accounting program to calculate accounts payable. Keep your bills together, whether you receive them as emails or snail mail. Add the amounts of all of the bills in your inbox or physical file to find your accounts payable balance. Also, include any other sums you've accrued that won't be included in your digital or paper bills. For example, if your employees have worked hours for which they haven't yet been paid, include these amounts in your accounts payable balance, unless you use a separate entry for payroll liabilities.
How Accounts Payable Affects Your Balance Sheet
Like any other liability, accounts payable affect your balance sheet by offsetting your assets to determine your total net worth. If you bought materials and used them in items you've already sold, you've already spent this money and used the products or services you bought with it, even if you haven't yet paid the bill.
You still have the money you need to pay the bill and it's included in your assets, but in essence, the funds have already been spent, so they're also included as liabilities. If you've bought the items but haven't yet used them, you'll also enter them back in as part of the inventory sum in the assets column. The process of making all these entries may seem unnecessarily tedious, but it yields accurate information about your company's net worth and also gives you a useful picture of how your assets and liabilities are distributed.


These are unprecedented times for Canadians. The Canadian Trucking Alliance supports the Government of Canada and all provinces in every way to mitigate the spread of COVID-19.
However, yesterday provinces began issuing statements regarding quarantine recommendations for Canadians leaving and returning to Canada. Our economy depends on trade with the United States – 70 percent of which is moved by the trucking industry and includes all essential products Canadians depend upon in these uncertain times, including medical and sanitation supplies fighting this virus as well as other emergency relief and food products.
The trucking industry and its drivers are an essential service. Self-quarantines for drivers leaving the country, who have not tested positive for the virus, would bring our economy to a grinding halt and jeopardize the public safety of Canadians. It is essential that distinctions are maintained between voluntary travel by the general public and those operating in vital international and domestic commerce. CTA would ask all levels of government examining their quarantine policies involving international travel and domestic trade to keep in mind that truck drivers are an essential service. The unintended consequences of not specifically considering this job class and its international travel requirements as an essential service could be catastrophic for the economy.


No one can take from you what is truly yours unless you allow them, which applies to your dreams. Too often in life, we let others define who we are and what we can achieve. Carole Mosley-Braun so pointedly said, “Defining myself, as opposed to being defined by others, is one of the most difficult challenges I face.” Yet, it is a challenge we must rise to if we are to reach our full potential. No one knows what is inside us, the desire to be great. It is not uncommon that those that tell us we can’t are themselves afraid of branching out beyond their comfort zone. Then, out of jealousy, some are frightened that you will reach your potential and leave them behind. We can not allow ourselves to be influenced by their negativity; it may even be necessary to assess should these people even be part of our life. Not everyone is meant the path with you. There will be times as you walk that path, you’ll stumble and fail. When that happens, you need people who believe in you and offer you encouragement to get back up and keep moving toward your dreams. Not someone who doubts you and is quick to tell you that you’ll never do it, you know you can, but surrounding yourself with negativity can cause doubt to creep in, and the slightest bit of doubt may be enough to prevent you from achieving your dreams.


Abstract
For colorectal liver metastases (CRLM), surgical resection is the only potentially curative therapy, but even successfully resected patients often face disease recurrence, leading to 5-year survival rate below 50%. Despite available preoperative stratification strategies, it is not fully elucidated which patients actually benefit from CRLM resection. Here we evaluated osteopontin, a secreted glyco-phosphoprotein, as a biomarker in the context of CRLM resection. Tissue levels of osteopontin were analysed in CRLM using reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry. Pre- and postoperative osteopontin serum concentrations were analysed by enzyme-linked immunosorbent assay (ELISA) in 125 patients undergoing resection of CRLM as well as 65 healthy controls. Correlating with an upregulation of osteopontin tissue expression in CRLM, osteopontin serum levels were significantly elevated in patients with CRLM compared to healthy controls. Importantly, high pre- and post-operative osteopontin serum levels were associated with a poor prognosis after tumour resection. Patients with initial osteopontin serum levels above our ideal cut-off value of 264.4 ng/mL showed a significantly impaired median overall survival of 304 days compared to 1394 days for patients with low osteopontin levels. Together, our data suggest a role of osteopontin as a prognostic biomarker in patients with resectable CRLM that might help to identify patients who particularly benefit from liver resection.
Keywords OPN biomarker CRLM prognosis CEA CANCER EXPRESSION RESECTABILITY THERAPY


2022 AWARD WINNERS Dustin Tart
Dustin is a breakout leader who represents the advancement of leadership in nursing by embracing discovery and integrating innovation, technology and practical approaches to improving patient care delivery. He previously received the Ernestine Davis and Edward L. Cole Award for Excellence in Coronary Care Unit Nursing, in 2017. This year, he is being recognized for his innovative strategies that are transforming our processes. The primary example is his work in creating a launching Duke University Hospital’s new Patient Response Program, which proactively identifies patients at risk for clinical deterioration and intervenes to stabilize patients and prevent unanticipated transfers to an ICU.
INTEGRITY
In 2019, the hospital sought opportunities to improve early identification of deterioration. This nominee was promoted from an ICU Clinical Lead to a Program Manager to initiate the Patient Response Program (PRP) to address this opportunity. Building the program from the ground up, he partnered with other clinical experts, leaders, and interdisciplinary team members to establish a programmatic approach to rapid response and early identification of clinical deterioration. Prior to this, one of the adult ICUs managed rapid response events and no proactive approach was used to identify or prevent deterioration.
This nominee, who previously worked as a Rapid Response Team (RRT) nurse, brought forward several evidence-based strategies to implement proactive care. He identified three main roles that the Patient Response Team (PRT) should have: 1) enhanced/proactive rounding; 2) response to RRT events; and 3) bedside education for frontline intermediate/stepdown team members. In addition to this work, the PRT was tasked to operationalize SepsisWatch, a predictive model to identify patients suffering from Sepsis.
EXCELLENCE
He is a Principle Investigator (PI) for quality improvement and research projects. Currently, he is leading a study titled, Evaluation of a Patient Response Program on Patient Outcomes and Staff Satisfaction (IRB Pro00109251). This nominee partners with a nurse scientist and nurse leader to evaluate the effect of a proactive PRP using evidence-based interventions, including proactive bedside rounding and education on patient outcomes and staff satisfaction. The primary aim of the project is to decrease the number of unanticipated transfers to the intensive care unit at Duke University Hospital, and the secondary aim is to improve the support of intermediate/stepdown nursing teams in identifying patient decompensation and escalating concerns related to patient condition. This nominee is leading the intervention by initiating the PRT and the work that drives this model of proactive care. He is dedicated to disseminating knowledge to address current and future needs. His innovative thought process, relationship-building skills, and commitment to improving patient care are qualities that lead him to success in creating and embracing discovery.
INNOVATION
This nominee strives to improve care delivery and patient outcomes through a data-driven approach. He led efforts to implement strategies that facilitate early identification of patient deterioration in the intermediate/stepdown setting. He leveraged innovative technology and created consistent workflows to guide proactive rounding. His work also enhances the team’s ability to respond to emergencies, including Rapid Response, Code Blue, and Stroke Codes. Before this team, our Rapid Response Team was underutilized and lacked any proactive approach for identifying patients who were deteriorating.
The key indicators of this work defined by the nominee and colleagues include rapid response volume, unanticipated transfers to the ICU, and staff satisfaction. Between fiscal years 2020 and 2021, our hospital had a 20.7% increase in rapid response events, with an average of 175 events per month in 2021. Next, implementation of the PRT and the proactive identification of deterioration led to a 29.3% decrease in unanticipated ICU transfers between March 2020 and March 2021.
COLLABORATION
While this nominee uses technology and data to make decisions, he holds a strong ability to build relationships and influence people. He is conscious of leading people and modeling the American Organization of Nursing Leadership’s Nurse Manager Competencies, which reflect on the importance of “fostering a culture where interdisciplinary team members are able to contribute to optimal patient outcomes and grow professionally.”
The structure of the PRP provided this nominee the opportunity to initiate a Behavioral Emergency Response Team (BERT) under a similar structure to the PRT, fulfilling a hospital need. Because the model used for PRT is flexible, the nominee partnered with clinical experts across the health system, including Clinical Education and Professional Development, psychiatric health providers, Nursing, Chaplains, Security, Performance Services, and many others, to create the new BERT.
CARING
The Chaplain Services Team collaborated with the Code Blue Oversight Committee, which the nominee is an active member of, to establish a process for Family Presence During Resuscitation (FPDR). Historically, families would not be present during resuscitation of their loved one, which contradicts our Professional Practice Model. Swanson’s Theory of Caring guides us toward “avoiding assumptions, centering on the one cared-for, assessing thoroughly, seeking cues, and engaging the self of both.” The FPDR process provides a safe, consistent way for loved ones to witness the resuscitation efforts. This work exemplifies Swanson’s Theory of Caring, specifically through the Caring Behavior of Knowing, which is defined by “striving to understand an event as it has meaning in the life of the other.” Research has shown that for families who wish to observe resuscitation efforts, there were many benefits. This nominee was a champion for this work and led the collaboration between the Code Blue Oversight Committee, Chaplain Services, PRT and local nursing teams. He helped draft the wording for an update to the Code Blue Policy and led the integration with the local teams through nursing education.
IMPACT STATEMENT
This nominee uses advanced leadership skills to transform our hospital’s clinical emergency response processes, and leads efforts to improve patient outcomes, reduce burden and stress on the frontline staff, and enhance available resources.
Dustin Tart BSN, RN, CNML, CCRN-CMC
Nursing Program Manager
Patient Response Program
Duke University Hospital
Award:


Divorce Is a Mitzvah: A Practical Guide to Finding Wholeness and Holiness When Your Marriage Dies by Rabbi Perry Netter, Afterward by Rabbi Laura Geller, Jewish Lights Publishing, $16.95 The Get: A Spiritual Memoir of Divorce by Elise Edelson Katch, Simcha Press, $10. In the Talmud, the tractate on divorces appears before the tractate on marrying. The wry explanation for this curious order? It’s better to learn the cure before getting the disease. If the metaphor holds, two recent books on Jewish divorce demonstrate that the cure can be as varied as the disease.
Rabbi Netter’s
Divorce Is a Mitzvah (the title is a line by Rashi) is a constructive, sensible, even hopeful book that attempts to mitigate the scars and the stigmas usually associated with divorce. He weaves the story of his divorce from a wife of seventeen years with practical information, psychological explanation, and readings of traditional Jewish sources. He is especially forthright on the importance of making divorce as safe as possible for the children, to which end he devotes two full chapters. Netter and his wife gathered their three children on the family marital bed to break the news that they were divorcing; this to convey the message that despite the changes to come they would still be a family. The difficult but also healthy, holy path, advises Rabbi Netter, is for the ex-spouses to actively co-parent the kids, to subordinate their pain with one another to meet the needs of their children.
Rabbi Netter wants the gel to be understood as a meaningful ritual rather than the businesslike implementation of a contract. The get, he believes, has the power to provide closure to a failed relationship; if approached consciously, its ritual can allow man and woman a final, emotional un-coupling. He deftly narrates the grief he felt at his own gel, and likens a divorce to a death—the death of a marriage, of innocence, and of an intact family. And he calls for more organized support for the divorcee within the Jewish community, something akin to the support we give to comfort a mourner.
Elise Edelson Katch’s memoir,
The Get testifies to how scaring and unreasonable divorce can be. Edelson Katch, a prominent Denver therapist, has brought to print a haunting tale that, sadly, reads more like untouched diary entries than a crafted work. She and her husband were both nonobservant Jews, free spirited children of the 1960s, when they fell in love and married. When their daughter was three years old, they joined a havurah. Ten years later, during what Katch believed was a temporary separation, her husband, who had increasingly been drawn to a nearby congregation of “black hats,” initiated proceedings for a gel. Edelson Katch tells of late night telephone calls from an Orthodox rabbi she never met who harassed her with whispered questions for information needed to write the gel: “What is your name, what is your father’s name?” Her husband, who does not attend their daughter’s bat mitzvah, dates a friend of Katch, and quite conveniently loses most of his assets, continually asks her for a gel. Edelson Katch refuses. She is not ready; she wants their civil divorce finalized first. When she does consent, she gets an Orthodox bet din. In a room with three men who will not meet her eye, she feels deeply shamed. She too yearns for a meaningful context, a ritual to help her mourn the death of her marriage. I found it particularly piercing that Katch, who throughout the book conveys a sense of her own genuine need for spirituality, be it New-Age affirmations or the lighting of Shabbat candles, should find her marriage so torn and herself so hurt by religion coming to her via the patriarchy. Karen Propp is the author of two memoirs, In Sickness & In Health: A Love Story and The Pregnancy Project: Encounters with Reproductive Therapy. She lives in Cambridge, Massachusetts with her husband and son.


Breaking down leveraged and inverse exchange-traded products
E*TRADE Securities08/30/21
Summary Leveraged and inverse exchange-traded products (ETPs) are complex investments that may provide amplified gains, but also substantial losses. Generally, leveraged and inverse ETPs are not intended to be held longer than one day. They carry significant risks and generally have higher management fees and expenses than traditional ETPs. Leveraged and inverse ETP performance can also be drastically different than the stated performance objectives, if held longer than one day. Before investing in leveraged or inverse ETPs, you should fully understand how they work and read the prospectus. What are leveraged and inverse exchange-traded products?
Leveraged and inverse exchange-traded products (ETPs) are considerably different than traditional exchange-traded products. They come with unique risks that investors should be aware of before incorporating them into their portfolios.
Leveraged ETPs are designed to amplify the daily movement of a benchmark. Inverse ETPs aim to replicate the daily movement in the opposite direction. An inverse ETP might strive to multiply a benchmark’s performance in the opposite direction, making it a leveraged inverse ETP.
When considering the differences between leveraged and inverse ETPs and traditional ETPs, it is important to highlight that leveraged and inverse funds use derivatives and other leveraged strategies to achieve their amplified benchmark-tracking strategies. What makes them even more complex? The underlying investments—typically futures, swaps, and other derivatives—have expiring lifecycles and must frequently be “rolled forward” or reset as the underlying products expire. This means that they have a much shorter and targeted time frame than the benchmarks they track.
Leveraged and inverse ETP examples
To illustrate, let's consider a conventional ETP, a 2x leveraged ETP, and a -2x inverse ETP that follow the same index. We won’t include underlying fees in these examples for simplicity, but keep in mind there are costs that come with these investments, which will detract from the ETP’s performance.
Typically, if the benchmark index rose 1% on a given day, then: A conventional ETP, which attempts to match the index performance, could rise 1% on that day. A 2x leveraged ETP, which aims to double the index performance, could rise 2% on that day. A -2x inverse ETP, which seeks a negative 2x return, could decline 2% on that day.
These are examples of what could happen in just one day. When held for longer than one day, the performance of leveraged ETPs can significantly decrease due to compounding, the fund's daily rebalancing, and other risk-related factors when it comes to derivatives trading like backwardation and contango.
For example if the benchmark index rose 1% over two days: The conventional ETP, which attempts to match the index performance, could rise 2% over two days. The 2x leveraged ETP, which aims to double the index performance, could rise 4% over two days. The -2x inverse ETP, which seeks a negative 2x return, could decline 4% over two days. Investing in leveraged and inverse ETPs
Advanced or professional traders may use leveraged and inverse ETPs in day trading or as a hedging strategy over a single trading session.
These ETPs are complex and should be monitored daily, so they are typically not a good choice for novice investors or long-term investors with buy-and-hold strategies. While some investors mistakenly believe a leveraged or inverse ETP multiplies the long-term performance of an index (or the inverse of an index), leveraged and inverse ETPs generally only seek to multiply such performance over just one day. Significant losses can result if they are not managed properly or held for longer than one day. Over the long-term, leveraged and inverse ETPs typically do not perform the same as the multiple or inverse return of their stated benchmark.
Pros and cons to consider
One advantage of leveraged ETPs is that they allow an investor to get more exposure to market movements without investing more money or buying on margin.
Inverse ETPs also have advantages, such as giving investors a way to profit or hedge existing positions during market declines without employing shorting strategies, as the process for buying inverse ETPs is often easier and less costly than shorting.
However, both leveraged and inverse ETPs have several significant potential downsides to consider, including the risks described above relating to holding leveraged and inverse ETPs for longer than one day, as well as unique risks from added leverage, which can increase volatility and rebalancing. The longer an investor holds an inverse or leveraged ETP, the greater the chance of potential loss given their volatile nature. These ETPs may also suffer from lower liquidity. Additionally, fees, costs, and taxes tend to be higher because the funds require more frequent trading, which can cut into an investor’s profits.
Also, ETP investors buy and sell shares of the products on exchanges, as opposed to transacting with the product itself. As a result, ETP investors are exposed to the risk, among others, that the market price of an ETP’s shares will not be equivalent to the daily net asset value (NAV) of the ETP’s shares.
The bottom line
Investors who use these ETPs should fully understand how they work, including all the material risks, and why they are using them.
Read the fund's prospectus, including details on its objectives, investment strategies, costs, and risks, before you make an investment decision. Those who choose to invest in leveraged or inverse ETPs should use extreme caution.


Résumé
This paper addresses assembly issues in life-cycle engineering design. It outlines a method that supports the designer in making assembly considerations. The basic idea is to incorporate commonly accepted Design For Assembly (DFA) rules into the
axiomatic design theory. In our approach, we represent these DFA rules as constraints and functional requirements on the design, along with suggestions on suitable physical solutions, at different levels in the functional and physical hierarchies. An example illustrating use of the method is provided. The validity and usefulness of this approach have been successfully tested in cooperation with two Swedish companies.


Study explores how environmental factors increase IBD risk
A recent study identified several environmental chemical agents, including a common herbicide, that may boost gastrointestinal inflammation, increasing the risk of inflammatory bowel disease (IBD).
The study was conducted by researchers at Brigham and Women’s Hospital in Boston, Massachusetts, and published in the journal,
Nature. According to the study’s authors, it’s well established that environmental factors are associated with autoimmune and inflammatory disease, however, scientists have struggled to identify how specific chemicals influence inflammation. For this study, investigators sought to reveal the mechanisms behind how certain chemicals contribute to IBD.
To begin the investigation, researchers integrated IBD genetic databases with a large Environmental Protection Agency database. The database, ToxCast, included biochemical data on consumer, industrial, and agricultural products. Scientists then tested the chemicals predicted to modulate inflammatory pathways on a zebrafish IBD model. Using a machine learning algorithm, scientists also identified an additional 20 chemical candidates that likely promote inflammation. Of these chemicals, the study zeroed in on the herbicide, propyzamide, commonly used to control weeds in sport and crop fields.
After further analysis of the herbicide on both zebrafish and mice models, findings indicated that propyzamide interfere with a transcription factor linked to immune regulation known as the aryl hydrocarbon receptor (AHR). Researchers determined that AHR is responsible for suppressing a proinflammatory pathway, the NF-κB-C/EBPβ-driven response, revealing the mechanisms behind how the herbicide leads to increased intestinal inflammation. According to researchers, C/EBPβ, was previously identified as a genetic biomarker for IBD.
These findings, according to the study’s authors, identify how exposure to specific environmental chemicals is associated with gastrointestinal inflammation, which may contribute to new methods of IBD prevention and treatment.
“As we learn more about the environmental factors that might contribute to disease, we can develop state and national level strategies to limit exposures,” said Francisco Quintana, PhD, an investigator in the Brigham’s Ann Romney Center for Neurologic Diseases. “Some chemicals don’t seem to be toxic when tested under basic conditions, but we do not yet know about the effect of chronic, low-level exposures over decades, or early on in development.”


When people ask me what do you do, for the last twenty-five years I've answered, "I'm a writer." Sometimes I add, "An author."
If the questioner still looks blank, I'll say, with authority, "I'm a professional writer."
I've learned to define myself in a powerful tone because so many people have odd assumptions about a woman writer. Several years ago, for instance, a chipper young teller at the bank window asked me, "What are you doing today?"
Eager to get moving, I replied somewhat crisply, "I'm writing. Like I do every day. I'm a writer."
"Oh, how nice," she said, with syrup in her voice. "It gives you something to fill your time."
"Fill my time? I have plenty to do. Writing is my passion. It's a career," I fumed.
Clearly unaware of the nerve she had touched the teller repeated, "How nice for you," before she began the transaction.
Other strangers comment, "You must be so disciplined. I hate writing," indicating they assume I'm forcing myself into an unpleasant activity.
But it's not like that. Writing is my passion, my treat. The days when I get to compose sentences, let my mind run loose and my fingers dance on the keyboard, are among my happiest. Perhaps it's because I waited so long to have this chance, to truly find my voice and my form.
Like many women I raised children while working, often with two jobs, and in addition engaged with my community and attended night school, first completing my bachelor's degree and continuing on in graduate school. I did snatch midnight hours to write, mostly poetry and philosophical musings.
Tucking these furious notes deep into the back of my desk, I thought about all the women in history—herstory—who stole moments while laundry dried on the line and babies napped, women hiding manuscripts in shoeboxes. I felt part of a long subversive trail, leaving crumbs for other women to find.
It took decades to find a style that fit me perfectly: the personal essay. My form wouldn't be feminist poetry or academic discourse, although I flourished in a doctoral program, but accessible essays serving equality. I had published newspaper essays on child-centered education in my 20s, but by my 30s I unashamedly used the "I" viewpoint to tell a personal/political story.
Using writing as a tool of activism came naturally, meshing my two great passions. The era encouraged the form. In the 1970s, with the explosion of women's magazines and papers, our stories began to see widespread print. This, after all, was the device we had used in consciousness-raising groups. I had needed those years, with nightly writing sharpening my skill, to claim the form.
But above all were writers like Adrienne Rich and Ntozake Shange, whose choreopoem For Colored Girls Who Have Considered Suicide / When the Rainbow Is Enuf had electrified Broadway. They, along with James Baldwin, Audre Lorde, Muriel Rukeyser, Grace Paley, Vivian Gornick, and others I absorbed like water, had abandoned the supposed objectivity of the white male author's omniscient viewpoint. When these older white men wrote of pain, it had come detached from social life: a lost love (Auden) or a fleeting moment of beauty (Shelley and Keats).
Now all these new writers, mostly women, focused on a first-person voice embedded in their times, "gaining access to their emotional as well as political lives on the page," as the poet Claudia Rankin would later introduce Adrienne Rich's Collected Poems 1950–2012. The disembodied voices of earlier generations of essayists and poets gave way to a storm of outrage: children napalmed, Black bodies brutalized, women denied agency in every area of our lives. The writer engaged herself. Nothing happened "out there."
By the late '70s these women had created a new literary landscape, one that invited me to participate. Rich wrote in "Diving into the Wreck": "The words are purposes. / The words are maps." This was an urgent art. "Art means nothing if it simply decorates the dinner table of power which holds it hostage." Rich, with the others, dared us to take ourselves seriously, create new language that could forge a path out of our wilderness.
They created an opening I ran through. Living in the heart of a vibrant women's community, I was ready to write my way into my own voice, which was emerging in tandem with its subject: people of color and women on the rise.
I began to publish my personal essays in local women's journals, national underground papers, and eventually mainstream media. Time after time, my pieces got reprinted, generating so much interest that eventually a publisher wanted to collect them in a book.
That overture came twenty-five years ago. Now my sixth commercially published book has launched, becoming internationally available.
So when people tell me how sweet it is that I have "something to fill my time," I shake inside, wanting to scream, "Would you tell Albert Einstein how nice it is that he can jot down a little math, or physics, to fill his obviously lonely, empty hours? No? Well then, don't say it to me."
But I don't. Instead I smile and repeat, "It's a career," hoping to impart some sense of the serious work a woman is capable of.
Especially if she's a writer.


When it comes to grief, it is important to recognize that grief looks different for everyone and can affect individuals of all ages. Individuals process the emotions surrounding grief in myriad ways, and the time frame is highly dependent on the individual and their attachment to whomever/whatever was lost.
The purpose of grief counseling is to help individuals work through the various stages and range of emotions one may feel after a loss. Common stages of grief include denial, anger, bargaining, depression, and acceptance. Again, there is no set timeline or process of grieving, and the stages of grief can be experienced in any amount and order.
What are the different types of grief and their manifestations? Complicated --- occurs when the symptoms of grief persist for up to a year or longer, and individuals experience... Intense sadness and emotional distress Feeling empty/hopeless Desire to reunite with a loved one Persistent thinking about the deceased individual/cause of death Trouble engaging in good memories of the lost individual Avoiding objects, places, people that remind them of their loss Detachment and isolation from support network Traumatic --- unprepared to lose an individual; loss occurs suddenly; symptoms may occur hours, days, weeks, or months after the traumatic incident Broken Heart Syndrome --- during the grieving process, the body may release stress hormones that can cause part of one's heart to swell, beat unevenly, and beat irregularly Depression and Grief --- if one is grieving, a depressive episode can be triggered, making the grieving process worse What techniques are used in grief counseling? Main stages of processing: Accept the reality of the loss Wade through the pain the grief has brought about Adjusting to life without the deceased individual How to maintain a connection with the deceased while also moving on with one's own life Therapeutic techniques: Guiding the client to discuss the loss (with as much detail as if comfortable), what the person meant to the individual, and the circumstances surrounding the passing Discuss feelings and emotions (in any form) surrounding the loss Cultivating coping mechanisms to handle difficult events, such as holidays, anniversaries, or birthdays Learning that grief is a normal process and is expected How to move on
Here at Madrigal, we are committed to addressing issues related to grief in a holistic manner.
*This information was adapted from Web MD. Click this link for more information.*


NLRB Rules Dues Checkoff Must Continue After Collective Bargaining Agreement Expires
In a decision that (again) throws out decades of legal precedent, the National Labor Relations Board (NLRB) issued a ruling in October stating that employers must continue to collect and provide dues to unions after a collective bargaining agreement expires. This decision is yet another monumental shift by the Biden board.
In a 3-2 decision in
Valley Hospital Medical Center, Inc. d/b/a Valley Hospital Medical Center and Local Joint Executive Board of Las Vegas, the NLRB held that as part of maintaining the status quo in the terms and conditions of employment, dues checkoff, or the process of collecting dues and sending them to a union, must continue after a labor contract ends. 371 NLRB No. 160 (2022).
The NLRB initially took up this issue in
Bethlehem Steel, and held that employers may cease dues checkoff after the expiration of a collective bargaining agreement. 136 NLRB 1500 (1962). Like union security, no-strike, arbitration, and management-rights clauses, the NLRB subsequently (and consistently) considered dues checkoffs to be another term that an employer may unilaterally change after the expiration of the agreement and not subject to the employer’s obligation to maintain the status quo of the terms and conditions of employment as established in NLRB v. Katz, 369 U.S. 736, 743 (1962). This line of precedent had been controlling on the issue until 2015, when the Obama board overturned it in Lincoln Lutheran of Racine, 362 NLRB 1655 (2015).
In
Lincoln Lutheran, the Obama board first adopted the position that Bethlehem Steel was erroneously decided and lacked any compelling justification for the proposition that dues checkoff needed to continue after a collective bargaining agreement ended. After the board’s shift in composition following the election of President Trump, the Trump board overturned Lincoln Lutheran and reinstated the holding of Bethlehem Steel in Valley Hospital Medical Center, 368 NLRB No. 139 (2019) ( Valley Hospital I).
Now, three years later, the Biden board has again rescinded
Bethlehem Steel/Valley Hospital I for the Obama board’s holding in Lincoln Lutheran.
Board Chairman Lauren McFerran was joined in the decision by board members Gwynne Wilcox and David Prouty. Board members John Ring and Marvin Kaplan, who were in the majority in
Valley Hospital I, dissented, arguing that dues checkoff provision are a unique exception to bargaining rules. Because the Taft-Hartley Act prohibits employers from deducting dues absent explicit consent to a bargaining agreement, they argued dues checkoff cannot continue in the absence of a valid collective bargaining agreement.
Following the NLRB’s August 2022 decision in
Tesla, which significantly expanded an employee’s ability to wear union insignia in the workplace, this is the second major, precedent disrupting decision of the Biden board, and it is shaping up to certainly not be its last. With broad new rules being promulgated by the NLRB and other significant longstanding doctrines like Joy Silk also in the crosshairs, it is seemingly a matter of when, and not if, the NLRB will make its next major move in advancing its robust pro-labor agenda.


Economists believe that the post-Covid hiring crunch in the US could be a turning point for academic inflation, marked by the need for businesses to revisit their policy positions and withdraw absolute rules such as hiring people with four-year college degrees.
David Deming
David Deming, economist and professor of public policy at the Harvard Kennedy School and director of the Malcolm Wiener Centre for Social Policy, retweeted a discussion on whether the post-Covid hiring crunch could be an inflection point for degree inflation in the US.
According to some experts, eliminating college degree requirements, especially for middle-skills job roles, could help businesses fill job vacancies, save money, as well as reduce employee turnover.
A 2017 Dismissed by Degrees study provides an overview of the increased interest in skills-based hiring. It highlights how the movement to cut unnecessary education qualifications was becoming popular among private employers before the Covid-19 pandemic hit in the US. The country was marked by record-low levels of unemployment and numerous unfilled jobs that gave workers more power in the labour market.
Will the post-Covid hiring crunch be an inflection point for degree inflation? I spoke to LinkedIn’s Talent Blog about lessons from our @HarvardHBS report Dismissed by Degrees, along with research by @Harvard @ProfDavidDeming and others. Read the post: https://t.co/cMyXClgNUj
— Joe Fuller (@JosephBFuller) June 8, 2021
Constantin Gurdgiev
Constantin Gurdgiev, economist and former editor of Business and Finance Magazine shared an article on the Covid-19 economic recession being different than others in which corporate profits seem to be booming in the US. As a result, this could be signalling potential economic recovery from the damages inflicted by the pandemic.
Experts add that the passing of the recession has been both abnormal and dramatic, shifting expectations for the recovery to unusual levels. Reports suggest that market power of producers is rising from the beginning of 2020 till date, while non-financial corporate profits continue to boom till date and in the second quarter of 2021, indicating a healthier economy. The Covid-19 pandemic, as a result, has transferred wealth from the people to organisations who have managed to trade through the virus crisis.
True Economics: 8/6/21: This Recession Is Different: Corporate Profits… #Corporate #profits, #Covid19, #investment, #pandemic, #Profits, #recession, S&P500, #SPX, #SPY, #stocks #financeandeconomy #economy #economics https://t.co/NdnjETnFp4
— Constantin Gurdgiev (@GTCost) June 8, 2021
James Picerno
James Picerno, a financial journalist and editor of the Capital Spectator blog, shared an article on the recent surge in US inflation, with hints of a peaking rebound after the pandemic lows suggested by the Inflation Trend Index (ITI ), which provides guidance on pricing activity.
Economists believe that even though inflation is peaking, the pricing pressure can be endured. However, the debate over inflation is not yet over in the US, with the Federal Reserve arguing that the current increase in inflation is momentary and triggered by the economic rebound after the deep recession triggered by the pandemic. The alternative argument is that numerous factors will keep the economy running hot and hotter for a long time.
Deutsche Bank economists believe that inflation will continue to rise and that the Fed’s decision to endure this increase by waiving rate hikes is a threat to the economy. David Folkerts-Landau, Deutsche’s chief economist and his team for instance, state that the decision could create a deep recession leading to massive financial distress across the world, especially in the emerging markets.
— James Picerno (@jpicerno) June 8, 2021


We aimed to evaluate the effectiveness of acoustic radiation force impulse (ARFI) elastography in differentiating between hepatic lesions. The prospective study included 117 patients with liver masses. Shear wave velocity (SWV) values for lesions were determined by ARFI imaging and compared statistically. The difference between SWV values for benign and malignant hepatic masses was significant (p < 0.01). The threshold SWV value for malignant hepatic lesions was established at 2.52 m/s, and the sensitivity and specificity of this cut-off value were 97% and 66%, respectively. We concluded that ARFI elastography provides supplementary data that aid in the differential diagnosis of liver masses.


Maryland legislators are considering a new law that would put an end to income-based discrimination in real estate. The Home Act would prohibit landlords from rejecting renters who pay with Section 8 housing vouchers.
There are approximately 23 million landlords in the U.S., and currently, they are barred from turning away potential renters on the basis of race, sex, color, religion, national origin, marital status, familial status, disability, sexual orientation, or gender identity. However, they are able to reject applications from renters with housing vouchers, thus discriminating based on income.
According to the U.S. Department of Housing and Urban Development, the vouchers are intended to “assist very low-income families, the elderly, and the disabled to afford decent, safe, and sanitary housing.”
The program works by using federal funds to pay a housing subsidy directly to the landlord while the participating renter pays the difference. Ultimately, the landlord receives the full payment. Yet many landlords choose not to rent to individuals and families with this payment method.
Landlords who do accept Section 8 housing vouchers are often located in impoverished neighborhoods with poor healthcare, limited transportation access, and high crime rates. By allowing limited voucher acceptance in safe neighborhoods, the state of Maryland, supporters of the bill say, is perpetuating the cycle of poverty.
Of the 86,004 real estate brokerage firms in the U.S., many of those in Maryland argue that the voucher program puts additional burdens on landlords. They have expressed concerns regarding rent limits, government approval for rent increases, constraints on evictions, and additional inspections.
Adam Skolnik, the executive director of the Maryland Multi-Housing Association and owner of 34 rental units, believes that compliance with the Section 8 voucher program should be optional.
“We believe in the fair housing laws,” he said. “This is genuinely different than religion or skin color. There are undue burdens that go along with the vouchers and that’s why we believe this bill should never see the light of day again.”
On the other hand, proponents of the Home Act argue that the bill will protect voucher-holders from homelessness, particularly veterans and the elderly who are consistently turned down and forced to live in impoverished neighborhoods far from their families.


File(s) under permanent embargo Giving the people a voice? Experiments with consultative authoritarian institutions in China
journal contributionposted on 01.09.2010, 00:00 authored by Baogang HeBaogang He, S Thøgersen
In the last decade Chinese consultative authoritarianism has been renewed through many political and administrative innovations and tools. Authoritarian rule in China is now permeated by a wide variety of consultative and deliberative practices. These practices stabilize and strengthen authoritarian rule, leading to deliberative authoritarianism, an advanced form of consultative authoritarianism. This paper discusses two experiments—deliberative polling at Zeguo, Zhejiang, and a township election in Ya'an, Sichuan. Through these two cases we examine the direction which the development of consultative authoritarianism is presently taking, and the potentials and limitations of such input mechanisms in an authoritarian setting.


The case concerned a recycling company called Browning-Ferris Industries in Milpitas, California, which used a temporary staffing agency called Leadpoint to source workers. A Teamsters local representative tried to organize the employees, but did not just want to negotiate with Leadpoint — they wanted Browning-Ferris to qualify as a “joint employer,” reasoning that bargaining would not be effective unless it also included the larger company that determined the conditions of the working environment.
A regional labor board disagreed, and the Teamsters appealed the decision to the National Labor Relations Board. The NRLB chose to apply a much broader definition of “employer” in ruling that both Browning-Ferris and Leadpoint were “joint employers,” reversing a labor standard in place since the 1980’s.
While the decision has been hailed by independent contractors and subcontractors, corporations and pro-employer groups have vowed to fight the ruling.


Drug pricing in the United States has been a political hot topic in recent years. On July 24, 2020, President Trump signed four executive orders on lowering drug prices. This multifaceted issue has numerous stakeholders with far reaching financial impacts. The backdrop of the current global pandemic creates additional complications for pharmaceutical companies seeking to bring COVID-19 treatments and vaccines to market, as these companies could be judged harshly if pricing of their products is not seen as reasonable by the public.
The pharmaceutical industry in the United States is structured to provide companies and investors economic incentives to engage in product development in exchange for fruitful returns throughout product launch. In recent years, drug pricing in the United States has been heavily scrutinized, with many arguing that companies are abusing regulated monopolistic periods and marketing drugs at unjustified prices.
An analysis published in 2018 by the America’s Health Insurance Plans (AHIP) association stated that on average, approximately 700 drugs had increased their price by 10 percent or more annually during the past five years. In 2019, the Senate Finance Committee held a congressional hearing with seven pharmaceutical executives to discuss increases to drug pricing, and H.R.3, a bill known as the
Lower Drug Costs Now Act, is awaiting Senate review after being passed by the House of Representatives in late 2019.
The COVID-19 pandemic has pharmaceutical companies under a microscope due to the world-wide demand for drugs to treat the disease. The non-partisan organization, Institute for Clinical and Economic Review (ICER), known as an independent watchdog on drug pricing, is closely following the pricing developments for COVID-19 treatments and vaccines.
On May 1, 2020, Gilead’s remdesivir received an emergency approval from the United States Food and Drug Administration for hospitalized patients with severe COVID-19 symptoms. Acknowledging the speculation regarding the potential pricing of remdesivir, Gilead published an open letter from its Chairman and CEO. The letter announced that in the United States, remdesivir would be listed at $3,120 for a 5-day treatment and discounted to $2,340 for certain government programs. Gilead also stated that by the end of 2020, it expected its investment in remdesivir to exceed $1 billion and that it felt the price set for remdesivir was well below its value.
In response to Gilead’s announcement, ICER stated that Gilead’s price was largely in line with its analysis of a reasonable price, given certain assumptions. However, some felt the pricing was too high given the pandemic and noting that Gilead received funding from the government for the development of remdesivir.
Outside of the United States, Gilead entered into non-exclusive licensing agreements with nine companies to manufacture and distribute remdesivir at a lower cost for developing countries and countries with substantial healthcare obstacles. Each licensee is able to set the price for its generic remdesivir product and the licenses are royalty-free until the World Health Organization ends the Public Health Emergency of International Concern or another drug is approved for the treatment or prevention of COVID-19.
The current pricing approach in the U.S. relating to COVID-19 treatments and vaccines continues to provide opportunities for companies and investors to engage in further product development. As a result, companies may be able to set higher prices in the U.S. and lower prices in developing countries. However, as seen with Gilead’s remdesivir, the pricing decisions made by pharmaceutical companies marketing COVID-19 treatments will be analyzed and scrutinized extensively.


Proactively analyze real-time event streams to identify leading indicators of incidents and take action before an outage occurs.
Most organizations monitor their infrastructure and receive alerts when incidents occur. However, the alerts often arrive too late, only after services and/or applications are unavailable or customers are severely impacted. This can have a critical and adverse effect on the business. Grok provides notifications of impending incidents so problems can be identified and resolved before they become incidents that affect services and customers.
Grok’s AIOps solution leverages machine learning to provide an early warning system. This early warning system allows users to proactively analyze event streams and identify similar characteristics leading up to an incident. Grok provides operational teams with early notification so issues can be addressed before an incident occurs. With Grok, operations teams can leverage event clustering and probable root cause capabilities to quickly isolate issues and repair the problem. Ultimately, these actions will prevent incidents from negatively impacting the business.


Sanitize Equipment and Supplies Clean and disinfect any item before and after an exchange. If you are unable to disinfect an item immediately, consider attaching a sign warning others not to use it and consider safely storing the item for several days before use. Consider CDC’s Guidelines for Cleaning and Disinfection.
Meet in a Public Location & Wear a Mask When making exchanges, we suggest following CDC’s Guidelines for Social Distancing. As many members of your organization no longer have access to all buildings, consider meeting in an open public space to make safe exchanges. Pickup locations can be coordinated between members through messaging in AxM.
Consider Delivery Some items may be eligible for shipping if members are willing to pay an additional cost. Consider offering delivery especially when exchanging items between different organizations through the external marketplace.
Consider Drop Zones If your organization does not have a common location to drop off and pick up packages, consider designating a safe and secure location in your building to make exchanges. Items can then be left for pickup without having to physically meet in person.
Wash Hands Before and After an Exchange Always disinfect items before and after an exchange, routinely wipe down your workspace, and thoroughly wash your hands throughout the day to reduce transmission of the virus.


Researchers led by a vascular team in Indianapolis found that carotid endarterectomy (CEA) remains the most-used strategy in carotid revascularisation, with CEA and transcarotid artery revascularisation (TCAR) showing decreased odds of stroke or death compared to transfemoral carotid artery stenting (TF-CAS).
Those were among the main findings delivered by Hanaa Dakour Aridi (Indiana University, Indianapolis, USA) during the 2022 annual meeting of the Midwestern Vascular Surgical Society (MVSS;15–17 September, Grand Rapids, USA) after an analysis of regional variation in patient selection, practice patterns and outcomes based on techniques used in carotid revascularisation logged in the Vascular Quality Initiative (VQI) from 2016–2021.
The research team divided 19 geographic regions into three quantiles based on the average annual volume of carotid procedures performed: low (956 cases), medium (1,533) and high (1,845) centres. They looked at a total of 126,768 carotid revascularisation cases, with most patients being asymptomatic. CEA was the most common procedure (>60%) across all regional groups, with 13% performed using TF-CAS and 17% with TCAR.
“Overall, there was a trend towards increased utilisation of TCAR since its introduction in 2016 up to 2021,” Aridi said, addressing the MVSS 2022 audience. “This seems to have been mirrored by an increase in the percentage of CEA cases.”
Aridi reported that she and her team found no significant differences in stroke and death between CEA and TCAR across the three regional volume groups.
“However, TF-CAS was associated with a higher odds of stroke and death compared to CEA, and TCAR was associated with a decreased odds of stroke or death compared to TF-CAS,” she added. “These variations were also seen when we analysed the regions individually.”
Despite significant variation in clinical practice, Aridi concluded that “no significant regional variation was observed in the outcomes of carotid revascularisation”.
“TCAR and CEA continue to show superior outcomes to TF-CAS across all regional groups,” she continued. “Our study identifies some gaps in adherence to societal guidelines, mainly in terms of intraoperative procedural variability that can potentially lead to worse outcomes. It also highlights the need for uniformity in management of patients with carotid artery disease.”
Raghu Motaganahalli (Indiana University School of Medicine, Indianapolis, USA), the study’s senior author, told
Vascular Specialist: “What we are seeing is TCAR has grown at the cost of CEA, not at the cost of TF-CAS. We would love to see growth happening at the cost of TF-CAS because it is probably at a higher risk of stroke and complications.”


September 30, 2021, marks the first-ever National Day for Truth and Reconciliation. Today, we honour the Survivors of government and church operated residential institutions (referred to as Indian Residential Schools), their families and communities, and the many children who never returned home. We also acknowledge the harms of colonization experienced by generations of First Nations, Inuit, and Métis peoples across this land.
Today is yet another opportunity to learn and engage in the deep work of decolonization and Reconciliation that lies ahead, and to reflect on the HIV burden carried disproportionately among Indigenous communities. As a sector, our journey along the path toward Truth and Reconciliation must be grounded in self-reflection and self-sufficiency. Also required is an acknowledgment of our privilege as settler organizations, of the inequitable distribution of resources, and contrition for our sector’s historical perpetuation of a colonialist and white supremist system.
Too often we have allowed systemic racism, anti-Indigenous discrimination, and a failure to consistently offer culturally relevant care and services to exist as barriers to Indigenous Peoples seeking support. As settler organizations, we have a duty to name and acknowledge our role in the intergenerational trauma faced by many Indigenous Peoples related to the ongoing and undue burden of HIV transmission propelled by colonialism and racism and discrimination. We also recognize the intergenerational traumas caused by the residential “school” and child welfare systems.
As settlers, incumbent on us,
not Indigenous Peoples, is the work of identifying gaps, harms, missteps, and setting clear goals along the path toward Reconciliation. It is time to move away from and beyond the historically ineffective and tiresome frameworks and prescriptive efforts to improve services and access for Indigenous people living with HIV and AIDS.
As ever, we must all continue to interrogate our often-idle commitments to enacting the Calls to Action from Truth and Reconciliation Commission established in 2015. We must continue to self-educate, reflect, and confront the disgraceful legacy of the residential “school” system, and the ways in which colonization continues to oppress, harm, and traumatize First Nation, Métis, and Inuit people.
As we move through this National Day for Truth and Reconciliation, we recognize and honour the decades-long history of leadership and action among Indigenous HIV/AIDS organizations as well as Elders and Knowledge Keepers serving communities in each of the four regions, and across the land.
Embedding Reconciliation into your organization
The HIV sector’s Reconciliation in Action Guidance document supports service providers to undergo the critical steps of self-reflection, self-education, and self-assessment at all levels of their organizations, and to build trust and develop relationships with partners, Elders/Knowledge Keepers and Indigenous people living with HIV/AIDS.
The guidance supports a commitment to listening deeply and heeding partner advice and input, particularly concerning the lack of meaningful engagement and inclusion of Indigenous people living with HIV/AIDS within our organizations and the broader sector.
Suggested Resources for Basic Self-Education Need support?
If you are a Survivor and need emotional support, a national crisis line is available 24 hours a day, seven days a week:
Residential School Survivor Support Line: 1-866-925-4419
Emotional, cultural and professional support services are also available to Survivors and their families through the Indian Residential Schools Resolution Health Support Program. Services can be accessed on an individual, family or group basis. In Ontario Call: 1-888-301-6426
Indigenous peoples across Canada can also go to The Hope for Wellness Help Line 24 hours a day, 7 days a week for counselling and crisis intervention.Call the toll-free Help Line at 1-855-242-3310 or connect to the online chat.


Medical implants are devices or tissues that are placed inside or on the surface of the body. Many implants are prosthetics, intended to replace missing body parts. Other implants deliver medication, monitor body functions, or provide support to organs and tissues.
Some implants are made from skin, bone or other body tissues. Others are made from metal, plastic, ceramic or other materials.
Implants can be placed permanently or they can be removed once they are no longer needed. For example, stents or hip implants are intended to be permanent. But chemotherapy ports or screws to repair broken bones can be removed when they no longer needed.
The risks of medical implants include surgical risks during placement or removal, infection, and implant failure. Some people also have reactions to the materials used in implants.
All surgical procedures have risks. These include bruising at the surgical site, pain, swelling and redness. When your implant is inserted or removed, you should expect these types of complications.
Infections are common. Most come from skin contamination at the time of surgery. If you get an infection, you may need to have a drain inserted near the implant, take medication, or even have the implant removed.
Over time, your implant could move, break, or stop working properly. If this happens, you may require additional surgery to repair or replace the implant.


Scale your RPA
- Without drowning in complexity
In this whitepaper, we set out to uncover the current state of RPA, the challenges organizations are currently facing, and the problems we foresee in the near-term.
Our general findings are, that many organizations are having difficulties in getting to a point where they can scale their RPA solution, and that this comes with an opportunity cost in the range of 10-20 million DKK in savings per year for Small-Medium Enterprises.
We present the focus areas these organizations must address to prepare for scale. Further, we uncover the challenges that organizations who are scaling will undoubtedly meet, in the form of exponentially increasing operational complexity. Finally, we present guidance on how to overcome them through building a solid foundation for the pillars of scalable RPA automation.


For over 25 years, the European Union Intellectual Property Office (EUIPO) enables to register european Union trademarks that are effective across all member states.
Registering a European Union trademark has many advantages. It allows to acquire an industrial property right which grants a monopoly on the protected sign for a ten-year period, which can be renewed indefinitely. It is a key asset that can be relied upon to secure protection against various infringements and possible counterfeiting.
Besides, European Union trademarks complement the protection granted under national trademark registrations, and enable to diversify a trademark portfolio.
It is unquestionable that trademark registrations generally represent a strategic interest (they notably enables to defend one’s trademark against competing trademarks or to protect oneself against the risks of counterfeiting). But filing for a European Union trademark also presents its own specific advantages.
A single registration procedure at a competitive cost
The European Union trademark guarantees a broad protection through a single application. The European Union trademark system grants the owner of the trademark an exclusive right in the 27 Member States of the European Union, which enables the creation of a prior right that can be enforced in all these countries.
This single registration can be done online by indicating a main and a second registration language, both of which must be official languages of the European Union. Moreover, this procedure does not require the translation of the documents claiming the priority of an earlier trademark if these documents are in one of the official languages.
The centralized procedure also generates significant savings compared to filing trademarks before the national offices of each European Union country. This allows to invest on a market of nearly 500 million consumers and at low costs.
An extended scope on overseas territories
Trademarks provide territorial protection and it is therefore paramount to know the geographical scope of protection of your intellectual property rights.
European Union trademarks now cover the entire French territory, including all overseas territories.
Indeed, Overseas Countries and Territories (OCTs), which include New Caledonia, French Polynesia, Saint-Pierre-et-Miquelon, the French Southern and Antarctic Territories, Wallis and Futuna and Saint-Barthélemy, do not belong to the European Union. However, recent specific provisions have confirmed that the protection of the European Union trademark does apply in these territories
Registering a European Union trademark has many advantages and represents a valuable investment, which should not, however, lead to overlook the interests of a national trademark such as a French registration with the National Industrial Property Institute (INPI),.
With IPzen, manage your trademark portfolio in a simple and secure way.
Please do not hesitate to contact us at contact@ipzen.com and book a free demonstration.
Designed by IP lawyers for IP professionals, law firms and corporations, IPzen has been developed with the requirements of managing an entire IP rights portfolio in mind. We keep you informed about the modern requirements and challenges of IP portfolio management through articles written by the IPzen team.


Philosophy in... Jonathan Egid ‘Philosophy in…’ is an interview series devoted to exploring the philosophical richness of lesser-studied languages from across the world. Despite recent acknowledgement of the global nature of philosophical thought, an overwhelming majority of work focuses on philosophy written in either classical languages (Greek, Latin, Arabic, Sanskrit, Mandarin) or contemporary European languages (German, French, English etc.). Although covering a hugely diverse body of literary philosophy, this focus nevertheless reflects the thought of only a small portion of humanity. This series aims to rectify this narrowness by examining the philosophical ideas of peoples the world over, especially those expressed in the languages, of Africa, Asia and the Americas. The aim of these interviews is not only to draw attention to the rich philosophical resources of lesser-studied languages and to promote them as media of philosophy, but also to expand the horizons of contemporary philosophy by paying close attention to how concepts translate across languages – sometimes seamlessly, ‘like birds over borders’, sometimes with great difficulty. Paying attention to the differences and similarities between the philosophical word-concepts across languages allows us to take stock of how much of our philosophy is conditioned by the grammatical peculiarities of a particular language or set of languages, and how much have a wider application. The project hus aims to foster a philosophical multilingualism in the conviction that philosophy can only lose out by narrowing its focus to a single language or language family. Interviews are conducted with philosophers who are experts in the chosen language, and explore some philosophical ideas distinctive of that linguistic culture, the history of their production and the methodology by which these insights are discovered, often in spaces at the interface of literacy and orality. Each interview concludes with a short list of ten philosophical terms in each language, and with suggestions for further reading.


Despite their outsized benefits, nature-based climate solutions continue to face multiple, persistent challenges. The Centre’s ambition is to deliver the tools and knowledge needed to overcome these barriers and unlock nature’s full potential.
However, doing so requires bold new technological and methodological approaches in science that are traditionally not funded by grants.
To come to fruition, the Centre’s work relies on philanthropic support. Donors, corporates, and foundations are catalysts for sparking the high-risk, high-reward, innovative, and disruptive new ideas and solutions we pursue. Funding needs vary greatly, and prospective donors are invited choose an initiative that best aligns with their interests, brand, or philanthropic vision.


While positive COVID-19 cases reported to the county appear to be on the decline in recent weeks, the Orange County Health Care Agency continues to report glitches in the reporting of tests and cases, leading to potential inaccuracies.
This is the second week in a row that the county has noted that the CalREDIE electronic laboratory reporting system has been experiencing technology issues, which may have resulted in lower daily COVID-19 positive cases received and tests reported recently.
The county has also issued alerts recently regarding the delay and duplication of tests. Last week, this resulted in the removal of more than 1,300 tests; and on Monday, a glitch resulted in a backlog of tests that added 17,133 tests to the system.
Of the 444,757 cumulative tests to date, 38,131 have tested positive, or 8.6%. The positive test rate has been declining in recent weeks.
Go here for more updates on how OC companies are responding to coronavirus.


COVID-19 pandemic: CDC adjusts return-to-work guidance for essential employees
Washington — The Centers for Disease Control and Prevention has released new guidelines intended to allow workers employed in “critical infrastructure” to return to their jobs more quickly after exposure to people with known or suspected cases of COVID-19.
According to CDC, the guidance covers workers in the following sectors:
Federal, state and local law enforcement 911 call center employees Fusion center employees Hazardous material responders from government and the private sector Janitorial and other custodial staff Individuals employed in food and agriculture, critical manufacturing, informational technology, transportation, energy, and government facilities
Previously, essential workers were instructed to remain home for a 14-day period after exposure or potential exposure. As outlined April 8 by CDC Director Robert Redfield during a White House coronavirus task force press briefing, the new interim guidance enables these workers to return to work if they do not have symptoms and follow various other precautions such as taking their temperature before going to work, wearing a facemask at all times, frequently cleaning and disinfecting workspaces, and practicing physical distancing on the job.
“We appreciate the dedication of all brave people responding to the challenges of #COVID19 to keep their communities safe and healthy,” Redfield wrote in an April 8 tweet, “and we will continue working to find ways to keep these individuals as safe as possible during this challenging time.”
During the briefing, Vice President Mike Pence said the guidance “will hopefully make it clear that there would be an opportunity for those people playing such an incredible role in our nation’s response to be able to return to work and to do so safely.”
CDC also recommends workers refrain from sharing headsets or other objects that are placed near their mouth or nose, and maintain a physical distance during mutual breaks. Workers are advised to stagger breaks, stay clear of break rooms, and refrain from sharing food or utensils. Employers are encouraged to increase the frequency of cleaning commonly touched surfaces and work with maintenance staff to increase air exchanges in work buildings.
Workers who become ill should be sent home immediately.


Sen. Sheila McNeill represents the 3rd Senate District which includes Brantley, Camden, Glynn, and McIntosh counties and portions of Charlton County.
On Monday, members of the 156
th Georgia General Assembly convened for the 2021 legislative session. With the legislature beginning a new biennium this year, many newly-elected lawmakers in both the House and Senate were officially sworn in to represent their districts on Monday. As a member of the Georgia Senate’s freshman class, I was proud to join my colleagues in marking the beginning of the legislative session by taking the oath of office. I am humbled and honored to have been selected by our community to fill the seat as the next Senator for Georgia’s 3 rd Senate District. I am ready to roll up my sleeves and tackle the critical issues facing our district and state. Of the multiple topics that require immediate attention from the legislature, passing a fiscally conservative budget and addressing our state’s flawed election system will be my primary focus within the coming weeks.
Last year’s legislative session took a turn with the arrival of COVID-19 in Georgia. With the General Assembly going into recess and finishing up the session in June, it was a year unlike any other. While we are more adjusted to life during a health pandemic, this year’s session will remain different from traditional sessions as lawmakers work to find solutions for pressing issues while taking necessary precautions to prevent the spread of COVID-19.
I applaud leadership in the House and Senate for staying proactive and implementing essential COVID-19 safety protocols for General Assembly members and staff. To prioritize the health and well-being of legislators and staff, we are undergoing mandatory virus testing twice a week, wearing masks when on Capitol premises, social distancing when possible and enhancing office sanitation practices. It brings me great joy to see the Georgia Department of Public Health’s vaccine distribution program in action across the state, and while this does not mean we need to stop practicing basic prevention methods, it does mean that there is light at the end of the tunnel as we work to end this global pandemic. Georgia is moving swiftly through our phased vaccination plan, with Georgians who are aged 65 and older now eligible to receive the vaccine. To receive the most up to date information on vaccine distribution in Georgia, visit the Georgia Department of Public Health’s website at: https://dph.georgia.gov/covid-vaccine.
Similar to COVID-19 bringing attention to areas within Georgia’s healthcare system that need significant improvement, the facilitation of the 2020 November General Election displayed the need for legislative action to further ensure the security and integrity of elections in Georgia. Sen. Ligon (R – Brunswick) served as a prominent voice in fighting to preserve Georgia’s integrity by leading the Senate’s efforts in investigating the numerous allegations of fraud that took place during the November election. Georgians deserve nothing short of fair and secure elections, and I pledge to continue Sen. Ligon’s (R – Brunswick) fight to ensure the General Assembly passes comprehensive election reform during this year’s legislative session.
Rest assured knowing that we are working diligently to not only continue investigation of any fraudulent activities that may have taken place in November, but to also pass much-needed legislation to prevent Georgia’s election system from being vulnerable to any illegal activity in future elections. Requiring identification for absentee voting, eliminating at-will absentee voting and forbidding the use of ballot drop boxes are all crucial items that I plan to focus.
With week one in the books, and as I continue to settle into my new office at the Capitol, everything is coming together as I embark on my first term serving the citizens of Georgia’s 3
rd Senate District. Senators were notified by the Lt. Governor and Senate Committee on Assignments of their committee appointments for this session, and I am pleased to announce that I have been appointed to serve as Vice Chairman of the Senate Natural Resources and Environment Committee, Secretary of the Veterans, Military, and Homeland Security Committee, and as a member of the Senate’s Education and Youth, and State Institutions and Property Committees. With decades of professional experience and a deep knowledge of the Georgia coast, I look forward to bringing my knowledge and expertise to these key committees.
As the legislative session progresses within the coming weeks, I encourage you to stay engaged as lawmakers review legislative initiatives that will shape our state for generations to come. I am truly honored to begin serving in this new role, and if I can be of any assistance, please do not hesitate to reach out to me.


The study, funded by the National Institute on Aging, recruited people who were 50 and older and homeless, and followed them for a median of 4.5 years. By interviewing people every six months about their health and housing status, researchers were able to examine how things like regaining housing, using drugs, and having various chronic conditions, such as diabetes, affected their risk of dying.


Why and How to Use Earthquake Straps
Earthquake straps are a must-have if you live somewhere prone to geologic activity. They'll hold heavy items of furniture in place during an earthquake to reduce the risk of damages and injury, and are especially highly recommended for bookcases, which can deal considerable damage if they topple.Posted — Updated
Start by unloading the furniture and pulling it from the wall to locate the studs. You can use a stud-finding tool for this or rely on the trick of tapping the wall and listening to hear the heavier sound indicative of a stud rather than insulation. It's important to anchor to a stud, because otherwise the strap may pull out during an earthquake. Depending on the design of the product you've purchased, you may need to attach it to the wall first or to the furniture first, so check the directions carefully. If you're working in masonry, concrete, or drywall, use an anchor into the stud; if you don't, the screw could pull out during an earthquake, sending the furniture toppling.
Prepare the item you're anchoring by drilling holes into the site where you'll be inserting the hardware, if directed to do so. Make sure to choose a point where the furniture is solid, rather than a weak point like a joint that could fracture when you drill or under the strain of an earthquake. Follow the installation directions for the strap carefully, taking care to apply the screws or fixative glue exactly as directed to avoid an unsafe installation.
For additional safety, you might want to consider installing barrier straps or strips at the front of the furniture if it's open or has doors that might easily swing out. These prevent items from tipping out in the event of an earthquake; for something like a bookcase, this can prevent injuries and a huge mess if the bookcase stays in place but all the books go flying. In the case of items like china and antique cabinets, the straps will prevent catastrophic damage to prized household items that might otherwise topple out during an earthquake. Adhesive gels and tapes are also available for specialty items like sculptures.
s.e. smith writes for Networx.com.


We engage in counseling for many reasons. At some point in our lives, nearly all of us experience depression, anxiety, relationship challenges, professional problems, or other disruptive hurdles.
We may question if we really need counseling, and might even blame ourselves for not being able to figure things out on our own. The reality is, sometimes we need an outside perspective to get on track or to understand why we keep having the same undesirable outcomes in our relationships, at work or in any other aspect of our lives.
I seeks to support you in understanding your behaviors, thoughts, and feelings, which result in personal discomfort and relationship conflicts. These challenges can often come from past experiences that were left unresolved, which we wish to avoid in the future. Some of these experiences can even be traumatic, causing a ripple effect leading to the creation of coping skills we use to protect ourselves.
These protective behaviors, or patterns, help us push forward. Unfortunately, sometimes these patterns are not always helpful to our personal success and growth. In some cases, the ways we have learned to cope and support ourselves may actually be an additional problem.
Our histories are infused with stories of strength, resilience, and survival. I believe people do the best they can with the resources available to them at the time. Together we will explore patterns of behavior, which no longer serve you. Our sessions always move at your own pace and without judgment.
I approach my work from an anti-oppressive, anti-racist, and trauma-informed lens. I acknowledge the world we live in is informed by systems and practices that impart oppressive power on individuals, groups, and communities. Our experiences and behaviors are often rooted in these systems, which can make us feel powerless. My intent is to actively acknowledge these systems and honor your lived experience while identifying forward movement in the completion of your goals.
I can help you increase your motivation to change, expand your ability to express yourself, improve your communication skills, and identify/implement relationship boundaries, which are more beneficial to you.
Whether you have short-term or long-term goals, I am excited to meet you and work with you in realizing your potential!


This week’s show explores the importance of having a clear vision and crafting your code. David Heinemeier Hanssen, dhh, co-owner and CTO of 37signals, shares the story of his rise to the C-suite and the challenges he faced when starting the company. He joins Etienne de Bruin to discuss how his company has grown over time.
Some ideas you’ll hear them explore are:
David considers himself a programmer, not an engineer. Engineer, he says, should be a protected title for people who actually have engineering degrees.
Most programming languages are not designed for the programmer, but are designed to contain and relegate the programmer as the “problematic character that’s driving it from behind the keyboard.”
David and his business partner were both students of bad businesses, getting a close-up view of what not to do which later informed their decisions in building Basecamp. This valuable insight, along with their combined skill sets in programming, design, and business operations, allowed them to approach entrepreneurship from a unique lens. “We had a healthy degree of utter arrogance and exuberant ignorance, and through those things, a commitment to doing things from first principles,” he shares.
Once you’ve made enough money that no one can threaten your livelihood, you achieve a distinct degree of inner freedom that allows you to stand up for your principles.
There are aspects of hardship that are good for you, and they will only make you stronger.
A lot of productivity is about realizing the value of doing nothing, the value of not creating more. The inherent creation value in destruction and inaction is huge and should not be overlooked.


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